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In fact, she had a strong negative sense of self and a critical inner voice. While Cathy had some of the traits of BPD (emotional regulation difficulties, self-harm and thoughts of death), she did not have difficulties with a lack of identity – a key characteristic of BPD. We spoke about her diagnosis of BPD and realised that it did not encapsulate all the difficulties she had. We initially focused on building a collaborative formulation of Cathy’s difficulties. However, she still felt very sad at times, and continued to struggle with social anxiety and loneliness, as well as recurrent flashbacks to the sexual assault and childhood events. DBT helped her build distress tolerance skills so she could reduce self-harm and manage her mood better. She was preoccupied by thoughts that she was a failure, that she would never get better and that she was going “crazy”.Ĭathy had tried dialectical behaviour therapy in the past, a first-line treatment for BPD focused on helping people learn to regulate emotions, manage distress and create better relationships. She didn’t know how to manage tough emotions and used alcohol and self-harm to numb herself, eventually being diagnosed with BPD. If you are a survivor of childhood trauma and have struggled with OCD, therapy can be a great way to start healing.In adulthood, she experienced episodic bouts of depression. Each pathway here is individualized and depends on the unique factors of the client. Some clients may also need to verbally recount past traumas to process through related emotions and sensations. This helps to unpair obsessions and compulsions and teaches tolerance of anxiety through mindfulness, breathwork, etc.
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For example, the client is exposed to something that triggers an anxious response (obsessions, fear-based thoughts, etc.) but sits with the anxiety with new coping skills (instead of using a compulsion to reduce anxiety). Exposure and Response Prevention (ESP) is one of the more effective forms of treatment to eliminate compulsions and gain new ways of productively working through anxiety, therefore releasing the individual from the dreadful cycles and symptoms of OCD. OCD, however, does not have to be permanent. Many people with OCD often fear harm will come to others if compulsions aren’t completed. Whether or not the obsessions and compulsions are directly related to their experiences of trauma, these responses come from attempts at resolving intense feelings of anxiety and internal dysregulation (which were forged as a result of trauma). OCD is a pattern of obsessions (unwanted repetitive/intrusive thoughts) that drive compulsions (to reduce anxiety accompanying the thoughts). Most children who have sustained trauma adopt coping skills that help them feel in control of their environment-one of which can develop into Obsessive-Compulsive Disorder (OCD). For example, a physically abused child may discharge emotion by exerting violence toward others (which can provide a momentary sense of power that depletes quickly). Because unprocessed emotions and visceral remnants of trauma become trapped, the brain seeks to find alternative methods of expression in an attempt to rebalance the body and return to equilibrium however, these attempts ordinarily show up as repetitive symptoms that only serve as short-term solutions. This, in turn, can cause intense emotional dysregulation and imbalance as the child attempts to understand their experience(s). When trauma happens, the event overwhelms the child’s available coping mechanisms. Trauma can play a large part in shaping the formation of those connections in ways that are generally damaging and can cause long-term issues.
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This is the time in which beliefs are molded regarding ourselves, other people, and the world. Content/Trigger Warning: Please be advised, the below article might mention trauma-related topics that include types of abuse & violence that could potentially be triggering.ĭuring childhood, the brain forms connections based on our physical, emotional, and relational environments.